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Role of Health Technology Assessment
Assessment in Health Care, SBU
Technology means
Health Technology
The equipment, devices and drugs, andthe medical and surgical proceduresused in prevention, diagnosis, treatment,and rehabilitation.
Health Technology Assessment
The process of HTA
A systematic review of thescientific literature Countries with
agencies/institutions for HTA
A selection of completed
assessments by SBU
Working days lost due to
Working days lost due to
Sickness absence
Methods used in treatment of back pain
Number of studies on back pain
Grading of evidence
Strong evidence – consistent findings in two
or several scientific studies of high quality.
Moderate evidence – consistent findings in two
or several scientific studies of acceptable quality.
Limited evidence – only one study available
or inconsistent findings in several studies.
No evidence – no study of acceptable scientific
Low Back Pain
Low Back Pain
Technologies used in the
diagnosis of back and neck pain
Economic impact of evidence-based
treatment for back pain
Alcohol and drug abuse
– There are effective measures available for prevention, however, these are under-used.
Methods used in the treatment
of alcohol- and drug abuse
with no support of scientific evidence
Non-manual based therapies:
Preoperative routines
There is no evidence of benefit to the patient,nor to the surgeon or the anaesthesiologist,to perform routine examinations beforeelective surgery on otherwise healthypatients.
Bone density measurement
There are no scientific basis for recommendingbone density measurement in mass screening,selective screening, or as an extra componentin health check-ups of asymptomaticindividuals (opportunistic screening).
– Smoking– Low physical activity– Lack of oestrogen / calcium Screening for prostate cancer
The scientific evidence shows thatthere are no compelling reasons torecommend neither mass screeningnor opportunistic screening forprostate cancer A selection of current
• Prevention and treatment of obesity• Prevention and treatment of osteoporosis• Prevention of caries• Treatment of depression• Anxiety• Dementia• Chronic pain• Venous thrombosis• Hearing impairment• Treatment by sick-leave• Prevention of disease by physical activity SBU Alert
A selection among >50 assessments
of emerging technologies
• Antiplatelet agents – clopidogrel• Brachytherapy for prostate cancer• BNCT – Radiotherapy with neutrons for brain tumors• Bupropion in smoking cessation• Cardiac Pumps in treating chronic heart failure• Gene therapy• Growth hormone in children with idiopathic short status• Implantable defibrillators• Screening for colorectal cancer• Testosterone therapy in men with age-related hormone HTA within the EU
Totally over 100 people are involved in the project.
– Clearinghouse function– Emerging technologies Recommendations to EU
The European Commission should put in place a sustainable and properly funded support function for aEuropean Union-wide network on assessment of healthinterventions and technology.
This network should involve recognized organisations and agencies in the field of HTA, which will enable and facilitatethe coordination of assessment within the European Union.
The Commission will thereby demonstrate the benefits of these activities and the risks of not implementing them interms of quality of life, quality of care, and cost of healthcare.
”I swear by Apol o, the physician,and invoking all the Gods andGoddesses to be my witnesses thataccording to my ability and judgement and evidence based
information from HTA studies

I will keep this oath and stipulation.”



Best Practice & Research Clinical GastroenterologyIstituto Allergologico Lombardo, Piazza Monsignor Moneta 1, 20090 Cesano Boscone, Milan, ItalyS.C. Allergology and Clinical Immunology, Niguarda ‘Ca’ Granda’ Hospital, Piazza Ospedale Maggiore, 3, 20162 Milan, ItalyAdverse reactions to foods, aside from those considered toxic, are caused by a particularindividual intolerance toward

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